This report responds to a Congressional requirement to examine the Navy's advisory council recommendations for restructuring graduate medical education (GME) and to compare these with Army and Air Force GME closure activities. The report focuses on the specific recommendation of the Navy advisory council to drop GME at the Bethesda (Maryland) Medical Center while retaining GME at Portsmouth (Virginia). This decision was overruled by the Navy Surgeon General on the grounds that it had been agreed to concentrate Navy GME in four geographic locations, including Bethesda but not Portsmouth. Similar difficulties are reported for plans to eliminate Army GME positions in Texas and for the GME program closures planned by the Air Force. The report concludes that the services need commonly accepted guidelines and criteria for choosing GME reduction and closure sites and for involving those affected in the decisions. It also recommends that lessons can be learned from parallels in the private sector, which has also been reducing, closing, or otherwise modifying its GME programs. A summary of comments by the Department of Defense notes general agreement with the report's recommendations and plans to develop a directive providing GME program closure and consolidation guidance. (DB)